Village board will weigh in on Lake Placid ER conversion

April 18, 2013

LAKE PLACID - Village Mayor Craig Randall said his board will likely weigh in formally on Adirondack Health's controversial plan to convert the emergency room at its Lake Placid hospital to an urgent-care center after a pair of upcoming public meetings on the proposal.

Speaking at Monday night's village board meeting, Randall said North Elba Supervisor Roby Politi has asked his board to attend the meetings to hear what the community has to say. The mayor encouraged his board to do the same.

"And then I think we would both respectively or perhaps jointly make a strong resolution about our positions," Randall said. "I do think it's appropriate for this board and the town board to take a stand on it. I don't know what you gentlemen are hearing in the community, but my sense is this has not been well received."

While no decision has been made, Adirondack Health has said the volume of patients at the Lake Placid ER doesn't justify keeping it open, that it isn't equipped with modern medical technology, and that most seriously ill patients already bypass it and are taken to the Saranac Lake ER. Although it wouldn't be open around the clock and would have fewer staff, the organization has said the urgent-care clinic would provide "the same level of care." The move, which has been endorsed by the Adirondack Health medical staff, would also save the hospital an estimated $1 million.

Yet the proposal continues to spark concern in the Lake Placid community. Randall held up more than 100 pages of petitions, each containing 15 signatures, he's received in support of keeping the Lake Placid ER open. He said he attended an Adirondack Health-hosted meeting on the subject last Friday with other local leaders and elected officials. The mayor also listened to a presentation from Adirondack Health officials at a recent meeting of the Lake Placid Business Association.

"They are making a case for the future of our Lake Placid emergency room facility," Randall said. "Obviously at this point they are saying that can be replaced by an urgent-care center with no loss of service to the community.

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"The problems are many for the community," the mayor continued. "I think they've done a good job of deciding what works for the institution, but there has been no communication whatsoever with the EMS system in each of our communities, and it certainly will have significant impacts on our volunteer ambulance squads in all of our communities."

Leaders of ambulance squads in Wilmington, Keene and Keene Valley have said they would no longer bring patients to Lake Placid if the ER is converted to a 12-hour urgent care, and would instead bring them to the ER at Elizabethtown Community Hospital.

"That would likely mean that the number of admissions to AMC, when they're already showing declining admissions to the hospital, would be bypassing them completely and going to the east," Randall said.

"They're going to lose a lot of income if people go to Plattsburgh or Elizabethtown," said Trustee Peter Holderied.

Randall said the Lake Placid Volunteer Ambulance Service made 1,442 runs in 2012, based on statistics he said he was provided.

"Think about that if we have to have additional time for each run to get to an emergency room," the mayor said. "There has been some discussion that the squad could stop at an urgi-center. The problem in New York state is an ambulance squad cannot bill for stopping at an urgi-center. In theory, if they're staffing down the urgi-center, the question becomes, will the appropriate medical staff be available to take care of that patient?"

Randall served on the Placid Memorial Hospital board when it merged with the General Hospital of Saranac Lake.

"One of the most contentious issues in that negotiation was the continuation of emergency room services for Lake Placid," he said. "The agreement that was finally struck was they would continue to provide 24-7 emergency room services.

"None of this makes a lot of sense. (Adirondack Health's) board has an obligation to not only consider the views of the various medical people at AMC who are promoting this, but they also need to consider the greater health needs of the community at large."

Randall said local residents concerned about the proposal are hosting an organizational meeting at 7:30 p.m. April 29 at Nicola's restaurant on Main Street. He said he expects it will be well attended. Adirondack Health is hosting two public meetings at 6 p.m. on May 1 and 7 p.m. on May 8, both at the Lake Placid Center for the Arts.